Provider Demographics
NPI:1225695869
Name:ABRAHAMSON, LAUREN (CNM, NP, MSN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ABRAHAMSON
Suffix:
Gender:F
Credentials:CNM, NP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 N CLARET LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1285
Mailing Address - Country:US
Mailing Address - Phone:510-909-4485
Mailing Address - Fax:
Practice Address - Street 1:112 LA CASA VIA STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3059
Practice Address - Country:US
Practice Address - Phone:925-239-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011744363LW0102X
CA236036367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95011744OtherWHNP
CA236036OtherCNM